title: Fertility-sparing surgery in ovarian cancer extended beyond the ovaries: a case report and review of the literature.
abstract: BACKGROUND
  Much attention has been recently focused on the role of fertility-sparing surgery in patients with ovarian cancer. However, few data are currently available on the feasibility of conservative approaches in women with disease extending beyond the ovaries.
  
  
  OBJECTIVE
  This review article aims at summarizing the oncologic and obstetric outcome of patients with stage II-III ovarian cancer treated with fertility-sparing surgery. We also describe a successful conservative management of a stage IIC endometrioid ovarian carcinoma.
  
  
  METHODS
  A literature search through Medline was carried out to locate published articles using the following keywords for selection: 'Fertility-sparing surgery and ovarian cancer'. From every single case series, we retrieved data on patients with stage II-III disease submitted to conservative surgery.
  
  
  RESULTS
  We identified 21 patients with stage II-III disease receiving fertility-sparing surgery. Recurrent disease was observed in 9 women (42.8%), and 5 (23.8%) of them died of disease. In contrast, a successful obstetric outcome has been reported in 3 cases (14.2%).
  
  
  CONCLUSIONS
  Radical surgical staging remains the standard of care for all women with stage II-III disease. A fertility-sparing approach may be considered only in the presence of a favorable histology and a very strong fertility desire.
authors.affiliation: Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Petrillo
authors.forename: F
authors.initials: F
authors.lastname: Legge
authors.forename: G
authors.initials: G
authors.lastname: Ferrandina
authors.forename: A
authors.initials: A
authors.lastname: Monterisi
authors.forename: L
authors.initials: L
authors.lastname: Pedone Anchora
authors.forename: G
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000328:Adult; D018269:Carcinoma, Endometrioid / Q000473:pathology / Q000601:surgery*; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006651:Histocytochemistry; D006801:Humans; D007231:Infant, Newborn; D007813:Laparotomy / Q000379:methods*; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy